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劳伦斯-穆恩-比德尔综合征的肾脏受累。功能及影像学研究。

Renal involvement in the Laurence-Moon-Biedl syndrome. Functional and radiological studies.

作者信息

Linné T, Wikstad I, Zetterström R

出版信息

Acta Paediatr Scand. 1986 Mar;75(2):240-4. doi: 10.1111/j.1651-2227.1986.tb10192.x.

Abstract

The renal abnormality of the Laurence-Moon-Biedl syndrome (LMBS) was investigated in six patients. The glomerular filtration rate (CIn) and the effective renal plasma flow (CPAH) were evaluated by standard clearance techniques and the single injection method, and the maximal concentration capacity was estimated by the ddAVP test. The kidney surface area and length were related to the body surface area, as well as the lumbar vertebrae L1-L3, and the relationship with the GFR was studied. All six patients showed renal abnormalities: Five had small kidneys with reduced GFR and concentrating ability, and one had hyperaminoaciduria (but normal kidney size). Two patients developed terminal renal failure (one of them was successfully transplanted), illustrating the progressive character of the renal lesion. Three of the patients had had recurrent urinary tract infections, but the radiological changes of the kidneys were of the same character as in the others (symmetrical and irregular parenchymal reduction, and blunting and clubbing of the calyces). Since renal abnormalities, with considerable risk for progression to terminal renal failure, are common in the LMBS, regular urine cultures and blood pressure measurements are probably of great importance.

摘要

对6例劳伦斯-穆恩-比德尔综合征(LMBS)患者的肾脏异常情况进行了研究。采用标准清除技术和单次注射法评估肾小球滤过率(CIn)和有效肾血浆流量(CPAH),并通过去氨加压素(ddAVP)试验评估最大浓缩能力。研究了肾脏表面积和长度与体表面积以及腰椎L1-L3的关系,以及与肾小球滤过率的关系。所有6例患者均表现出肾脏异常:5例肾脏较小,肾小球滤过率和浓缩能力降低,1例有高氨基酸尿症(但肾脏大小正常)。2例患者发展为终末期肾衰竭(其中1例成功接受了移植),这说明了肾脏病变的进行性特征。3例患者曾反复发生尿路感染,但肾脏的影像学改变与其他患者相同(实质对称性不规则减少,肾盏变钝和杵状膨大)。由于肾脏异常在LMBS中很常见,且进展为终末期肾衰竭的风险很大,因此定期进行尿培养和血压测量可能非常重要。

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